Stomach and Intestine(Tokyo) Volume 54, Issue 8 (July 2019)

Clinicopathological Characteristic of Submucosal Invasive Non-ampullary Duodenal Adenocarcinoma, Report of 12 Cases Shoichi Yoshimizu 1 , Hiroshi Kawachi 2 , Yorimasa Yamamoto 3 , Kaoru Nakano 1 , Keigo Suzuki 1 , Mitsuaki Ishioka 1 , Kazunori Hijikata 1 , Yoshitaka Tokai 1 , Naoki Akazawa 1 , Sho Shiroma 1 , Ken Namikawa 1 , Yusuke Horiuchi 1 , Akiyoshi Ishiyama 1 , Toshiyuki Yoshio 1 , Toshiaki Hirasawa 1 , Tomohiro Tsuchida 1 , Hiromichi Ito 4 , Junko Fujisaki 1 1Department of Gastroenterology, Cancer Institute Hospital, Tokyo 2Department of Pathology, Cancer Institute Hospital, Tokyo 3Division of Gastroenterology, Showa University Fujigaoka Hospital, Endoscopy Center, Yokohama, Japan 4Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Tokyo Keyword: 非乳頭部十二指腸SM癌 , リンパ節転移 , 胃型形質 , 腸型形質 pp.1131-1140
Published Date 2019/7/25
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 Between April 2008 and April 2018, 12 patients with primary SM-NADAC(submucosal invasive non-ampullary duodenal adenocarcinoma)underwent treatment at our institution. This retrospective study aims to investigate the clinicopathological characteristics of SM-NADAC in 12 patients [median age:67(range:49-83)years ; 6 males and 6 females]. The median tumor size was 14(range:7-70)mm, but 4 patients had a small tumor(≦10mm). The lesions were located in the first, second, and third parts in 3, 8, and 1 patients, respectively. In addition, 10 of 12 tumors were located on the oral side of the papilla. Based on the macroscopic type assessment, 6 patients were evaluated(0-Is, 0-IIa), while 6 patients exhibited the mixed form(0-IIa+IIc, 0-IIa+Is). The histology of patients was as follows:pap(2 patients) ; tub1/tub2(7 patients) ; and por/sig(3 patients). The median SM invasion depth was 1,100(range:400-3,000)μm. Moreover, 6 of 12 patients involved a positive lymphovascular invasion. Overall, 46%(5/11)were lymph node metastasis-positive cases with lymphadenectomy. The immunophenotypes of tumors were as follows:gastric type(4 patients) ; mixed type(7 patients) ; and intestinal type(1 patient). Therefore, 92%(11/12)of SM-NADAC cases displayed gastric marker(MUC5AC, MUC6)expression. Notably, owing to the rarity of the disease, our sample size was small, which necessitates further evaluation of large-scale cases in the future.

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54巻8号 (2019年7月)
電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院